1. What women and midwives want
Our lives and future in your hands
Belinda Phipps NCT

6. The Importance of Birth

7. “It ranks as number 1 in my great moments”
“The way a woman gives birth can affect the
whole of the rest of her life - how can that not
matter - unless the woman herself doesn‟t
matter”

9. “It‟s something you never forget and it does
mark a huge transition in your life”
“Incredibly important”
“Nothing can compare to the experience of
giving birth and holding your child for the first
time. It definitely altered my relationship with
my partner - for the better”

11. “Life changing - more meaningful than all other
experiences”
“Birth experiences strike at the very heart and
soul of you, they touch new emotions not
experienced before and bring a whole new
perspective to life”

12. The Potential of Birth
• Empowering
• Affirming
• Identity changing
• Courage giving
• Advocate creating
• Healing

14. Post-traumatic stress
disorder
• „feeling in control during the labour and delivery and
knowing what to expect were important protective
factors against the development of PTSD‟ (Lyon,
1998)
• Czarnocka and Slade (2000) found that „women with
symptoms of PTSD were more likely to feel that they
had little control during the labour, to have higher
ratings of trait anxiety, and greater fear during the
labour‟

15. Safety is …
• A midwife you know and trust
• An NHS you trust
• Being listened to and taken seriously
• Good teamwork
• Feeling consulted and involved and supported to decide
• Affirmation
• Explanation
• A comfortable and comforting and clean place to be
• Being and feeling cared about and cared for
• Confidence you can cope

16. Safety is not…
• Being left alone in labour or other times
when frightened
• Being told off or threatened
• Professionals arguing with each other and
contradicting each other
• Being told your baby will die unless..
• Being unable to ask any question you want
without feeling silly

18. The ‘patient experience’
• 1. Patients are treated with dignity, kindness, compassion, courtesy, respect,
understanding and honesty.
• 2. … staff …have demonstrated competency in communication skills.
• 6. Patients are actively involved in shared decision making and supported to make
fully informed choices about investigations, treatment and care
• 7. Patients are made aware that they have the right to choose, accept or decline
treatment and these decisions are respected and supported.
• 11. Patients experience continuity of care delivered, whenever possible, by the
same healthcare professional or team throughout an episode of care.
• 12. Patients experience co-ordinated care with clear and accurate information
exchange between relevant health … professionals.
• 14. Patients are made aware of who to contact, how to contact them and when
to make contact about their ongoing healthcare needs.
NICE guideline QS15. Quality standard for patient experience in adult NHS services. NICE 2012.

19. Care Quality Commission
Maternity Survey 2007/2010
Question 2007 2010
Women who got the pain relief they wanted 64% 65%
Women with confidence and trust in the staff caring for them 68% 73%
Women whose birth partner was made welcome by the staff? (not asked) 84%
Women left alone by midwives or doctors at a time when it worried them? 26% 22%
Women who were spoken to in a way they could understand during 82% 84%
labour
Women involved in decisions about their care during labour? 70% 71%
Women with legs in stirrups at the birth 27% 30%

20. Fulfilment is …
• A midwife you know and trust
• An NHS you trust
• Being listened to and taken seriously
• Good teamwork
• Feeling consulted and involved and supported to decide
• Affirmation
• Explanation
• A comfortable and comforting and clean place to be
• Being and feeling cared about and cared for
• Confidence you can cope

21. Fulfilment is not…
• Being left alone in labour or other times
when frightened
• Being told off or threatened
• Professionals arguing with each other and
contradicting each other
• Being told your baby will die unless..
• Being unable to ask any question you want
without feeling silly

22. In order to have this I must do this
need action
safety A
Main stream
In order to have this
CONFLICT
aim
To be a good
parent B
In order to have this I must do this
fulfilment Less common
A
need
action

23. Midwifery 2020
“Women and their partners want a safe transition to
parenthood and they want the experience to be positive
and life enhancing. Quality maternity services should be
defined by the ability to do both.”
“Midwives should have a visible place in a community setting where women can choose to access them as the first
point of contact.”
“There are two key roles for midwives that are important if we are to achieve our vision: one is that midwives are
the lead professional for women with no complications, and the other is as the coordinator of care for all
women.”
“Each woman and her partner need a midwife they know and trust to coordinate their physical and emotional care
through pregnancy and until the end of the postnatal period.”

24. Midwife

26. In order to have this I must do this
need action
Provide high A Focus on one
quality care person
In order to have this
aim
Provide the
best care for
B
everyone
In order to have this I must do this
Provide some
care to many Spend some
people time with
A everyone
need
action

27. Number of midwives
Time

28. She came to me and calmly said we were just
going to chill out together, she asked why I was
scared of hospitals and was the only person who
actually listened to my fears. She actually 'said'
very little but her whole presence spoke
volumes, if that makes sense?. She advocated
for me and truly.

29. Who wants to solve these dilemmas?